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Rare and Extreme Types of Migraines

Written by Kimberly HollandMedically Reviewed on July 1, 2013 by George Krucik, MD, MBA

Some rare types of migraines can cause temporary paralysis or blindness, and can even mimic some very serious medical conditions.

More than 13 percent of Americans are
affected by migraines, severe pain in the head that is sometimes accompanied by
vision problems, nausea, vomiting, and dizziness. Rarely, however, migraines
can cause symptoms and complications in other parts of the body. These migraine
variants are named according to the part of the body that is affected. Most of
these migraine variants are very rare. Your doctor may be able to tell if your
symptoms indicate you have one of these rare or extreme types of migraines, or
another condition altogether.

Hemiplegic Migraines

Hemiplegic migraine affects 0.03 percent
of Americans. People with hemiplegic migraines experience paralysis or weakness
on one side of the body, disturbances in speech and vision, and other symptoms
that often mimic a stroke. The paralysis is usually temporary, but it can last
for several days. Two types of hemiplegic migraine exist:

Familial Hemiplegic Migraine (FHMR): FHM is an inherited genetic migraine disorder that
causes hemiplegic migraines. (Genetic testing can determine if a person has the
gene mutations that are associated with this migraine variant.) If a parent,
sibling, or child has FMR, the chances you will have FHM are higher.

Sporadic
Hemiplegic Migraine (SHM):SHM is associated with hemiplegic migraines that occur
in people without the genetic disorder and without a family history of
hemiplegic migraines. Both FHM and SHM are diagnosed after a person has
symptoms of a hemiplegic migraine on several occasions. However, if that person
does not have a relative with diagnosed hemiplegic migraines, doctors may
believe the person has SHM—both present the same way; the only difference is
the presence of the known genetic risk.

Ophthalmic Migraine

Ophthalmic migraines (also sometimes
called ocular or retinal migraines) are rare migraine variants characterized by
repeated instances of visual disturbances such as blind spots or blindness on
one side of the field of vision. These disturbances typically last between a
minute and an hour and usually occur before a migraine begins.

Ophthalmoplegic Migraine

Ophthalmoplegic migraine is a rare
migraine variant that is most common in young adults and children. This type of
migraine begins as an intense migraine pain behind the eye and includes double
vision or paralysis of the eye muscles that cause a droopy eyelid. Patients may
also experience vomiting and seizures during this type of migraine. Your doctor
might wish to also check for an aneurysm, a bulging spot in the brain, to see
if it may account for the symptoms.

Menstrual Migraine

As the name suggests, these migraines
are related to a woman’s menstrual cycle and the fluctuations of hormones that
precede it. More than half of women with migraines report a flare-up of
symptoms prior to having a period. Migraines caused by menstruation are
typically more severe and last longer than migraines at other times of the
month.

Basilar Migraine

Basilar migraine, also known as
Bickerstaff syndrome, typically causes dizziness and vertigo prior to a
headache. However, this migraine variant may also cause ringing in the ears,
slurred speech, loss of balance, syncope, and even loss of consciousness prior
to a headache. This type of headache is most common in adolescent girls and
young women, so researchers believe it is likely related to the hormonal
changes that primarily affect females at these ages.

Abdominal Migraine

Children are typically most affected by
abdominal migraines. Symptoms generally last one to 72 hours and include
nausea, vomiting, and flushing. For children who have been struggling with this
migraine variant for a longer period of time, symptoms may also include
attention deficit problems, clumsiness, or delayed development. This variant is
more common in children who have a family history of migraines.

Chronic Migraine

Patients who experience repeated and
ongoing episodes of migraine may have a variant called chronic migraine. (It’s
also sometimes called transformed migraine.) People with this variant typically
experience headaches on at least half of the days in a month; many will have
migraines daily or almost daily. This type of migraine typically begins in the
late teens or early 20s, and the frequency of migraines will increase over
time. These patients tend to overmedicate with over-the-counter and
prescription medicines that can actually make migraine headaches worse. Many
patients with chronic migraine also suffer from depression.

Vertebrobasilar Migraine

Migraines preceded by vertigo may be a
sign of vertebrobasilar or vertiginous migraine. Vertigo is a common complaint
for many people with migraine, but frequent and recurring episodes of vertigo
may be caused by a problem in the lower part of the brain.

Status Migrainosus

This very serious and very rare migraine
variant typically causes migraines so severe and prolonged that patients must
be hospitalized. This severe migraine can last several hours or even several
days. Most complications associated with this migraine variant arise because of
prolonged vomiting and nausea. Over time, you will become dehydrated, and you
will need intravenous treatment to stay hydrated.

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